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PLEASE NOTE: Recent changes have been made to this Test


 Recent changes for Cerebrospinal Fluid - Cytology

Recent changes for Cerebrospinal Fluid - Cytology

Date
Field
Changed From
Changed To
14th August 2020
Collection & Request Instructions

The sample with the least amount of blood is prefered for Cytology.

Collect CSF into three separate, sterile, screw-capped tubes provided (labelled 1,2 & 3)

Tube 1 is for Biochemistry (for Protein and Glucose) 0.5ml (10 drops) required

Tube 2 for Cytology 1.0ml (20 drops)  and/or Flow Cytometry (6ml)

For Flow Cytometry a minimum of 6ml is required  in Tube 2

For Flow Cytometry and Cytology a minimum of 7ml is required in Tube 2    

Tube 3 for Microbiology upto 10ml (Full tube)

Xanthochromia investigation requires a 4th tube containing 1ml of CSF.

The sample with the least amount of blood is prefered for Cytology.

CSF SPECIMEN INFORMATION – LABORATORY PROCESSING

Depending on the tests requested, 3-4 separate tubes will need to be provided.  Note that the tubes are numbered so that order of collection can be identified – this order should be carefully followed, so that the optimal sample can be used for the requested tests.  It is also important to consider the tests that are required, as this will determine how much CSF is needed in each tube.  See the matrix below for details.

TUBE 1 is used for Cytology.

TUBE 2 is used for Glucose, Protein and Flow Cytometry.

(centrifuged in the lab – the supernatant is used for Biochemistry analysis (glucose, protein) and the cellular pellet will be used for flow cytometry if required).

TUBE 3 is for Microbiological analysis (cell count, Gram stain and culture) and any further infectious testing (e.g. viral PCR, mycobacterial PCR and culture, cryptococcal antigen).

TUBE 4 will be required only for;

         (a) Creutzfeld-Jacob Disease (CJD) testing OR

(b) Xanthochromia analysis (wrap the tube in foil to prevent    sample deterioration due to light).

 

TESTS REQUIRED

MINIMUM REQUIRED VOLUME (mL)

TUBE 1

TUBE 2

TUBE 3

TUBE 4

CYTOLOGY. CHEMISTRY, MICRO/CULTURE

1.0-2.0

1.0

1.0-2.0

Nil

ADD FLOW CYTOMETRY

 

add 5.0-7.0

 

 

ADD OTHER INFECTIOUS MARKERS

 

 

add 2.0- 5.0-

 

ADD MYCOBACTERIAL CULTURE

 

 

Add 10.00

 

ADD CJD

 

 

 

1.0

ADD XANTHOCHROMIA

 

 

 

1.0 (foil)

 

Note, the ability to add further tests to a previously collected sample is dependent upon the volume provided.  Also, many tests (flow cytometry, cytology) can only be performed on fresh specimens.

 

Other specialised testing (e.g. oligoclonal bands) will be performed using the supplied samples.

 

Xanthochromia and CJD analysis cannot be performed on a blood-stained sample.

Processing Instructions

Must be stored in the fridge.

 

Must be stored in the fridge.

Out of hours CSF samples for routine testing can be stored in the AP refrigerator.

 

Notes

Out of hours CSF samples for routine testing can be stored in the AP refrigerator.

 

 

 

31st May 2019
Notes

out of hours CSF samples for cytology can be stored in the refrigerator for routine testing

Out of hours CSF samples for routine testing can be stored in the AP refrigerator.

 

Out of hours CSF samples for routine testing can be stored in the AP refrigerator.

 

31st May 2019
Collection & Request Instructions

CSF must be delivered to laboratory immediately; cellular degeneration occurs within 30 minutes.

The sample with the least amount of blood is prefered for Cytology.

Collect CSF into three separate, sterile, screw-capped tubes provided (labelled 1,2 & 3)

Tube 1 is for Biochemistry (for Protein and Glucose) 0.5ml (10 drops) required

Tube 2 for Cytology 1.0ml (20 drops)  and/or Flow Cytometry (6ml)

For Flow Cytometry a minimum of 6ml is required  in Tube 2

For Flow Cytometry and Cytology a minimum of 7ml is required in Tube 2    

Tube 3 for Microbiology upto 10ml (Full tube)

Xanthochromia investigation requires a 4th tube containing 1ml of CSF .

The sample with the least amount of blood is prefered for Cytology.

Collect CSF into three separate, sterile, screw-capped tubes provided (labelled 1,2 & 3)

Tube 1 is for Biochemistry (for Protein and Glucose) 0.5ml (10 drops) required

Tube 2 for Cytology 1.0ml (20 drops)  and/or Flow Cytometry (6ml)

For Flow Cytometry a minimum of 6ml is required  in Tube 2

For Flow Cytometry and Cytology a minimum of 7ml is required in Tube 2    

Tube 3 for Microbiology upto 10ml (Full tube)

Xanthochromia investigation requires a 4th tube containing 1ml of CSF.

External Transport Instructions

All out of hours specimens from Anglss and Maroondah should be sent to Box Hill ASAP for processing.

After hours cytology CSF can be prepared by microbiology staff. In the event microbiology staff are not in attendance and will not be called in, please call the Anatomical Pathology Scientist on call.

After hours cytology CSF can be prepared by microbiology staff. In the event microbiology staff are not in attendance please store in the AP fridge.

Method

CSF sample processing:

If Cytology/Flow Cytometry requested  : Tube 1-Biochemistry, Tube 2- Cytology/Flow Cytometry, Tube 3-Microbiology

If Cytology/Flow Cytometry not requested: Tube 1 and 3-Microbiology, Tube 2-Biochemistry

Any confusion between the terms cell count and cytology could be cleared up when the cell count is rung through to the requesting doctor by the scientist. At this point it could be determined whether cytology is a genuine request or not (all to be documented in F8 notes). The CSF can then be forwarded expediently to BHH for cytospin if required.

 

 

CSF sample processing:

If Cytology/Flow Cytometry requested  : Tube 1-Biochemistry, Tube 2- Cytology/Flow Cytometry, Tube 3-Microbiology

If Cytology/Flow Cytometry not requested: Tube 1 and 3-Microbiology, Tube 2-Biochemistry

Any confusion between the terms cell count and cytology could be cleared up when the cell count is rung through to the requesting doctor by the scientist. At this point it could be determined whether cytology is a genuine request or not (all to be documented in F8 notes).

 

 

Notes

out of hours CSF samples for cytology can be stored in the refrigerator for routine testing

Out of hours CSF samples for routine testing can be stored in the AP refrigerator.

 

Cerebrospinal Fluid - Cytology

Ordering information:

Cerner orderable: Cytology CSF

When ordering with other CSF tests please order in the same ordering conversation.

Out of businees hours urgent CSF cytology must be requested via discussion with the on call pathologist.

Alternate names:
CSF Cytology, Cytology CSF
Laboratory:
Cytopathology
Specimen types:
Cerebrospinal Fluid
Container types:
CSFCSF
Collection Instructions:

The sample with the least amount of blood is prefered for Cytology.

CSF SPECIMEN INFORMATION – LABORATORY PROCESSING

Depending on the tests requested, 3-4 separate tubes will need to be provided.  Note that the tubes are numbered so that order of collection can be identified – this order should be carefully followed, so that the optimal sample can be used for the requested tests.  It is also important to consider the tests that are required, as this will determine how much CSF is needed in each tube.  See the matrix below for details.

TUBE 1 is used for Cytology.

TUBE 2 is used for Glucose, Protein and Flow Cytometry.

(centrifuged in the lab – the supernatant is used for Biochemistry analysis (glucose, protein) and the cellular pellet will be used for flow cytometry if required).

TUBE 3 is for Microbiological analysis (cell count, Gram stain and culture) and any further infectious testing (e.g. viral PCR, mycobacterial PCR and culture, cryptococcal antigen).

TUBE 4 will be required only for;

         (a) Creutzfeld-Jacob Disease (CJD) testing OR

(b) Xanthochromia analysis (wrap the tube in foil to prevent    sample deterioration due to light).

 

TESTS REQUIRED

MINIMUM REQUIRED VOLUME (mL)

TUBE 1

TUBE 2

TUBE 3

TUBE 4

CYTOLOGY. CHEMISTRY, MICRO/CULTURE

1.0-2.0

1.0

1.0-2.0

Nil

ADD FLOW CYTOMETRY

 

add 5.0-7.0

 

 

ADD OTHER INFECTIOUS MARKERS

 

 

add 2.0- 5.0-

 

ADD MYCOBACTERIAL CULTURE

 

 

Add 10.00

 

ADD CJD

 

 

 

1.0

ADD XANTHOCHROMIA

 

 

 

1.0 (foil)

 

Note, the ability to add further tests to a previously collected sample is dependent upon the volume provided.  Also, many tests (flow cytometry, cytology) can only be performed on fresh specimens.

 

Other specialised testing (e.g. oligoclonal bands) will be performed using the supplied samples.

 

Xanthochromia and CJD analysis cannot be performed on a blood-stained sample.

Notes:

 

 

Result Turnaround Time:
72 hours
Laboratory Use Only
Storage Instructions:

Must be stored in the fridge.

Out of hours CSF samples for routine testing can be stored in the AP refrigerator.

 

Transport Instructions:

After hours cytology CSF can be prepared by microbiology staff. In the event microbiology staff are not in attendance please store in the AP fridge.

Laboratory Notes:

CSF sample processing:

If Cytology/Flow Cytometry requested  : Tube 1-Biochemistry, Tube 2- Cytology/Flow Cytometry, Tube 3-Microbiology

If Cytology/Flow Cytometry not requested: Tube 1 and 3-Microbiology, Tube 2-Biochemistry

Any confusion between the terms cell count and cytology could be cleared up when the cell count is rung through to the requesting doctor by the scientist. At this point it could be determined whether cytology is a genuine request or not (all to be documented in F8 notes).